Dr Rassman.Iam 44 years old & thinking of going on propecia to regrow my hair which has thinned out in the crown area.My question is
1. How effective is propecia for a 44 year old ?
2. Would I be facing greater side effects due to my age?
If propecia is not the way to go can you recommend something else that will re grow my hair .
Its genetic ,but my father suffered balding in the crown area much later in life .

thanking you.

Propecia is always more effective when the hair loss is more recent. Men in their 20s get a better response in regrowing hair than men in their 40s, assuming that the hair loss started in the 20s. At 44, you will most probably see ’stop loss’ effect more than a regrow effect. But on occasion, I actually see regrowth in men into their 70s, although this is not usual.

In your second question, I will assume you are addressing the side effect of a decreased sex drive. I always clarify the difference between sex drive and the ability to get and maintain an erection. Sex drive reduction is less common than an increased sex drive in the men I have treated. Men in their 40s have a 40% chance of having some form of erectile dysfunction (ED). Most men do not admit it (even to themselves) but I always ask men to ask themselves if their penis works as well as when they were 16 so that they focus upon the change in penis physiology that occurs when men get older. When the penis does not work as well as we like, then of course, the sex drive will be reduced. Viagra solves the problem for most men and I believe that the problem is more physiology and psychology than Propecia induced. If you go on Propecia and then ‘think’ that your sex drive is off, then try Viagra (or Cialis or Levetra) and see if that solves the problem. With a good working penis, the sex drive usually gets better, unless you are the 1% of men who do get a reduced sex drive with Propecia. To answer the question, yes older men sometimes get a reduced sex drive which is tied to ED, rather than Propecia.

I’ve had Laser treatments to remove the hair on my back and reduce the hair on my chest. I now have very little hair on my back and less on my chest.

Recently I’ve had a CATSCAN. My lymph nodes are irregular and I’m having a biopsy. I’ve been told I may have to do chemo.

I’m aware I can lose much of my hair during these treatments. I realize this is usually temporary. Will this have an effect in reversing any changes made by the Laser on my back and chest?

Thanks.

If the laser succeeded and the hair on the back and chest has been gone for more than a year or two, then the chemotherapy should not impact any regrowth of the body hair that has been removed. The reason I am saying this, is that laser hair removal (when it succeeds) kills the ‘root’ of the hair so that it will not regrow. As you probably know, the laser is about 50% effective at killing each hair, so after one treatment 50% of the hair will return within a few months of the treatment. With each successive treatment 50% of the treated hair dies, so after the second treatment 25% returns, and after the third is 12.5%, then 6%, then 3%, and so on. This assumes that modern hair lasers are used.

Your head hair (if you lose it with chemotherapy) has not been killed off, but rather a chemically induced telogen process will have been precipitated. Chemotherapeutic agents go after the faster growing cells of the body (cancers, hair, certain blood cells, sometimes intestinal cells) and that is the common thread that produces the side effects you may experience with such agents (anemia and white blood cell depletion, bleeding from depleted platelets, diarrhea and nausea from intestinal cell impact). The telogen process from chemotherapy is in the hair follicle and it usually reverses in a few months after the chemo stops. The drugs used vary and not all people lose their hair with some of the chemotherapy agents. Some of the newer chemotherapy agents are more targeted at the cancer and some of these other fast growing cells may not be impacted.

Thank You doctor for the advice on Propecia. I have started taking it now and within days my hair has improved. Yes, i do get proper erections but when i think of my penis….i dont…so i guess psychology is playing a part in not getting erection.

Anyways, can you please suggest some tests which i need to keep doing to check if my testeterone levels are normal (what i mean to say is tests which can check if my sexual organs are normal).

Thank You

There are doctors that specialize in sexual problems in men. If you are penis-focused, you may be causing your own sexual dysfunction, that is why a doctor who specializes in sexual problems may be a good starting point. They will be able to help differentiate between physical and emotional causes. You can have your doctor measure your testosterone levels to see if they are normal.

I am glad to hear that Propecia is helping, but I would expect that the benefits of it will take months, rather than days.

Hello –

Recently, I’ve had a heavier load of stress in my life within my marriage. Last night when I got my hair colored my stylist asked me what’s been going on in my world? The reason she asked, is because I was intensly more grey than normal on the crown of my scalp & the sides, my hair was lifeless and dull and when she washed my hair after coloring, she noticed alot of hair on the drain. I’ve noticed my hair greying much faster and the same thing with washing my hair at home in the shower, lots of hair on the drain. I’m 37 years old and female.
My question is: Is my hair greying faster, texture of my hair lifeless and dull and the hair loss on the drain due to heavy stress? Thanks for any help you can give.

Genetic female hair loss can be precipitated by stress which can also bring on the graying process as well. Changes in the character of the hair also occurs as we age, as well as from the stress. Sounds like you need to surround your stress better. Also see a good doctor for the diagnosis of genetic female hair loss.

I had really thick hair up until I was 16 years old. Since then it is about 1/3 the thickness. I have tried vitamins and have tried to eat alot of protein etc to help. I am 52 (female) and after all these years I cannot help but notice a pattern. During the winter months after December my hair will have regrowth with new hair and actually thicken to the point that my scalp is not visible. Is is possible that cold and sinus medicines such as sudafed, cough syrups, and antibiotics [non penicilin] have ingredients that would contribute to hair growth? As soon as the weather heats up in the summer my hair starts falling out again by the brush full. What do you think? Thank you for your time and consideration.

What you say is logical, it is just not what we normally see in humans. Why humans have developed asynchronous hair growth, why we do not grow and shed hair all at once and the evolution of this is not known. What you are suggesting is that in you there is some seasonal variation in your hair density and that shedding may occur as the seasons get warmer, I do not doubt your observations, but I do not have a basis for understanding it. I am convinced that in the summer when we sweat a great deal and get our hair wet from sweat, we may actually produce more friction when we brush or comb the hair. That might account for the hair that comes out when you brush your hair in the summer. Also, some people wash their hair more frequently in the summer when they are out and about because they get it ‘dirty’ more easily. That might explain what you are observing. Clearly, there is a suggestion that there is some middle ground in your history and that some climate problems do occur in the summer in your situation. Do you live in a warm/hot climate?

i am a 23 year old woman, who has always had VERY thick curly hair. I have noticed that my hair is much thinner and requires many more wraps of the hair tie to put it up in a pony tail. I am very upset and wondered if you had any clue what is going on. I do not have a receeding hair line or anything. how stressed out does a person have to be inorder to affect their hair? thanks

The internet is no place to get a good examination of your head, scalp, and hair. A good dermatologist should be a starting point. Some people get hair changes with age that is not necessarily diseased hair, and others get hair thinning and loss from medical problems (search woman’s hair loss on this site to see the many medical conditions that can cause hair loss). You need a good doctor to make an assessment of you and your problem. If you have genetic female hair loss, then hair loss can be a problem anytime you experience stress.

I am a male, 24 years old. My problem is that i dont have a single hair on my entire body, to my surprise i dont have a moustache. I feel so embrassed when i remove my shirt. Please help me with this major problem. Please suggest something to me so that i can have a hairy body like others and enjoy my life happily by removing my shirt.

Is this present in any other member of your family? First, I would want to know if your eyebrow and public hair is still present. If not, then you might have a medical condition called Alopecia Totalis, in which case you need to see a dermatologist who specializes in Alopecia. If you are late with beard and body hair and the eyebrow and pubic hair are sill present, then I would suggest that you wait out the DHT effect, which should eventually come sooner or later. People like me envy people with low beard growth. All of my sons went through the period that you are talking about, thinking that it will never happen. I even remember that when I was 22 and my father was a hairy beast.

HI, Dr. Rassman, I am an 18 years old female and I used to wear braids on and off for long periods during my life. This past June I decided to take them out to grow out my own hair. I started going to a hair dresser faithfully every 2 or 3 weeks and saw much improvement. Also during that time I started taking OTC diet pills and after a couple of visits to the hair dresser i noticed in August that i was losing hair below my crown. My hair dresser told me it might have been the stress of the braids that made the hair in that area stop growing and it was now regaining its strength. Since then, the area has grown and spread to the left side of my head. I am not sure if i should call these areas bald spots because there is still hair there, they are just very short compared to all the other areas. The temples, the back portion of my head, the top crown, and right side of my head still have all of its hair and i have not noticed any thinning. I am not sure why this is happening and need some advice on what steps I can take to grow back the hair in these areas.

Let the hair grow out for another 6 months and then make a proper assessment with a good doctor who understands hair. A good baseline also is a good idea just to have a measurement for the progress that you would expect to see and to rule out other problems. The differential diagnosis includes traction alopecia, female hair loss, and the huge variety of medical and scalp conditions that are discussed in previous blog posts (see Female Hair Loss category). A baseline assessment would include a full mapping of your head for miniaturization, which would then be remapped at about 6-8 months from now.